Page last updated at 08:18 GMT, Thursday, 3 July 2008 09:18 UK

Patient care 'has been transformed'

By Jane Hughes
Health correspondent, BBC News

The NHS is a very different place now from 60 years ago.

In the last six decades, there has been a revolution in the type and range of treatments available.

IMMUNISATIONS

Immunisation means some diseases which used to kill many hundreds of people a year have now been virtually wiped out in the UK.

Jonas Salk
Jonas Salk pioneered development of a polio vaccine

Back in the early days of the NHS there were regular polio epidemics - 8000 or so cases a year.

A vaccination programme was introduced in 1956, and cases immediately began to fall.

The last case of polio infection in the UK was in 1984.

Vaccination programmes have also helped minimise the risk of potentially fatal illnesses like tuberculosis, whooping cough and diphtheria.

And measles has gone from being a huge problem to a rare condition.

There were up to 800,000 measles cases a year in the late 1940s and early 1950s.

Vaccination began in 1968, and the last confirmed death was in 2006, though the number of measles cases has risen slightly since the controversy over the MMR vaccine.

FERTILITY

There have been huge advances in fertility treatment.

In 1948, a couple who couldn't have children had very few options.

In 2005, more than 11,000 babies were born as a result of IVF treatment.

The first test tube baby, Louise Brown, was born in 1978.

The development of IVF technology suddenly gave hope to thousands of despairing infertile couples.

Doctors went on to develop even more refined techniques like embryo freezing.

Judy Boothroyd was one of the first mothers to have a baby from a frozen embryo.

"We were very lucky IVF was available to us at that time," she said.

"By the time Emily was born I was nearly 39. I felt that time was running out. Had I been ten years older, it wouldn't have been possible."

Since then, IVF has been refined even further.

Today, more than one in four women under the age of 35 who undergo IVF go on to have healthy babies.

TRANSPLANTS

The NHS has witnessed a surgical revolution in the last six decades.

In its early years, the notion of transplanting an organ from one person's body to another seemed like science fiction.

But in 1960 the first kidney in the UK was transplanted - and in 1968 came the nation's first heart transplant, carried out at the National Heart Hospital in London.

Transplants are now revolutionising the life of thousands of people each year - in the last 12 months, over 3,000 people had an organ transplant.

Professor Peter Morris, from the Royal College of Surgeons, has worked as a transplant surgeon since the early days of the technology.

"It has been quite extraordinary," he said.

"Before kidney transplants, patients either survived on dialysis or died.

"It was one of the modern miracles of the 20th century, without question."

And the revolution is continuing - in 2005 came the first partial face transplant, carried out by doctors in France.

Now the Royal Free Hospital in London has been licensed to carry out the first face transplant here.

SURGERY

Surgery in general is very different today from the early days of the NHS.

Then, most operations were done by general surgeons - there were far fewer specialists.

The risks were much higher.

Patients were anaesthetised with heavy doses of opiates, which left them with unpleasant side effects, and they were kept in hospital for a couple of weeks or more, even for the most simple procedure.

Today, keyhole surgery, which became widespread in the 1990s, means recovery times are far shorter.

Day surgery is also increasingly common - cataract surgery, for example, is finished in a matter of minutes, with patients able to walk out of the theatre and go straight home.

Hip transplants, developed in 1972, are now routinely available, and help put thousands of elderly people back on their feet every year.

And plastic surgery has gone from being a treatment for accident and burns victims developed during the Second World War, to being a commonplace cosmetic procedure.

These are just some of the increasingly sophisticated treatments which have been developed in the last few years.

They have transformed people's lives, but also pose a growing dilemma for NHS.

How can they all be paid for, and who should receive them?





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